Organization
WESLEY W WALKER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY W WALKER MD (OWNER)
(229) 386-1300
Entity
Organization
Contact information
Practice address
1623 MADISON AVE, TIFTON, GA 31794-3757
(229) 386-1300
Mailing address
1623 MADISON AVE, TIFTON, GA 31794-3757
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
045022
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00797838A
—
GA
Enumeration date
01/25/2012
Last updated
01/25/2012
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